Provider Demographics
NPI:1528750932
Name:BEBERMEYER, LORA ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:ROSE
Last Name:BEBERMEYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1604 AYLWARD AVE
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:67439-2541
Mailing Address - Country:US
Mailing Address - Phone:785-810-1177
Mailing Address - Fax:785-472-5760
Practice Address - Street 1:1604 AYLWARD AVE
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:KS
Practice Address - Zip Code:67439-2541
Practice Address - Country:US
Practice Address - Phone:785-810-1177
Practice Address - Fax:785-472-5760
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2025-08-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant